Supplementary Material for: History of Adverse Pregnancy on Subsequent Maternal-Fetal Outcomes in Patients with Immunoglobulin A Nephropathy: A Retrospective Cohort Study from a Chinese Single Center

<b><i>Background:</i></b> Gestation complications have a recurrence risk and could predispose to each other in the next pregnancy. We aimed to evaluate the relationship between a history of adverse pregnancy and maternal-fetal outcomes in subsequent pregnancy in patients with Immunoglobulin A nephropathy (IgAN). <b><i>Methods:</i></b> A retrospective cohort study from a Chinese single center was conducted. Pregnant women with biopsy-proven primary IgAN and aged ≥18 years were enrolled and divided into the 2 groups by a history of adverse pregnancy. The primary outcome was adverse pregnancy outcome, which included maternal-fetal outcomes. Logistical regression model was used to evaluate the association of a history of adverse pregnancy with subsequent adverse maternal and fetal outcomes. <b><i>Results:</i></b> Ninety-one women with 100 pregnancies were included, of which 54 (54%) pregnancies had a history of adverse pregnancy. IgAN patients with adverse pregnancy history had more composite maternal outcomes (70.4% vs. 45.7%, <i>p</i> = 0.012), while there was no difference in the composite adverse fetal outcomes between the 2 groups (55.6% vs. 45.7%). IgAN patients with a history of adverse pregnancy were associated with an increased risk of subsequent adverse maternal outcomes (adjusted odds ratio [OR], 2.64; 95% CI, 1.07–6.47). Similar results were shown in those with baseline serum albumin &lt;3.5 g/dL, 24 h proteinuria ≥1 g/day, and a history of hypertension. There was no association between a history of adverse pregnancy and subsequent adverse fetal outcomes in IgAN patients (adjusted OR, 1.56; 95% CI, 0.63–3.87). <b><i>Conclusion:</i></b> A history of adverse pregnancy was associated with an increased risk of subsequent adverse maternal outcomes, but not for adverse fetal outcomes in IgAN patients.

<b><i>背景：</i></b> 妊娠并发症存在复发风险，且可在后续妊娠中互为易感因素。本研究旨在评估免疫球蛋白A肾病（Immunoglobulin A nephropathy, IgAN）患者既往不良妊娠史与后续妊娠母婴结局之间的关联。<b><i>方法：</i></b> 本研究为一项来自中国单中心的回顾性队列研究。纳入经肾活检确诊的原发性IgAN且年龄≥18岁的妊娠女性，依据既往不良妊娠史将其分为两组。主要结局为不良妊娠结局，涵盖母婴相关结局。采用logistic回归模型分析既往不良妊娠史与后续不良母婴结局的关联。<b><i>结果：</i></b> 共纳入91名妊娠女性，涉及100次妊娠，其中54次（54%）妊娠存在既往不良妊娠史。有不良妊娠史的IgAN患者复合性母体不良结局发生率更高（70.4% vs. 45.7%，<i>p</i> = 0.012），而两组间复合性胎儿不良结局发生率无显著差异（55.6% vs. 45.7%）。既往有不良妊娠史的IgAN患者后续发生不良母体结局的风险升高（校正后比值比[OR] = 2.64；95%置信区间[CI] = 1.07~6.47）。在基线血清白蛋白<3.5 g/dL、24小时尿蛋白≥1 g/天以及有高血压病史的亚组患者中，上述结果一致。IgAN患者既往不良妊娠史与后续不良胎儿结局无显著关联（校正后OR = 1.56；95%CI = 0.63~3.87）。<b><i>结论：</i></b> IgAN患者既往不良妊娠史与后续不良母体结局风险升高相关，但与不良胎儿结局无关联。